Salmonellosis symptoms

The incubation period of salmonella varies from several hours (with massive infection by the food route) to 5-6 days (with a contact path of infection or a small dose of the pathogen). The clinical symptoms, their severity, the sequence of appearance and duration of the course of the disease depend on the clinical form. Distinguish typical (gastrointestinal, typhoid-like and septic) and atypical (stale, subclinical) forms of salmonellosis. As well as bacteriocarrier.

Gastrointestinal form of salmonellosis in children is most common. Depending on the primary lesion of a particular gastrointestinal tract, gastritis, enteritis, colitis, gastroenteritis, enterocolitis, etc. Can be leading.

• Gastritis and gastroenteritis as a clinical syndrome of salmonellosis are observed mainly in older children and, as a rule, at the food pathway of infection (massive invasion). The incubation period is short, up to 1 day. The disease begins acutely, with pain in the epigastric region, repeated vomiting, an increase in body temperature to 38-40 ° C, a general weakness. The tongue is densely laid, dryish, and the stomach is moderately swollen. The disease can end within 2-3 days without the appearance of a loose stool (gastritis form). In some cases, this form of salmonellosis begins acutely, with pain in the abdomen, repeated vomiting, but note a sharp weakness. Hypothermia, cold extremities and a drop in blood pressure by the type of collapse. Most often, after the symptoms of gastritis, there is a diarrheal syndrome - a gastroenteric variant of the course. The chair is usually infrequent (3-5 times a day), mushy or liquid, plentiful, undigested, sometimes watery or foamy with an admixture of a small amount of clear mucus and greens. To varying degrees, symptoms of intoxication or toxicosis with exsicosis are expressed.
• The enteritis form of salmonella often develops in the contact pathway of infection in young children with concomitant diseases (rickets anemia, hypotrophy, etc.). The disease begins with abdominal pain. There may be nausea, vomiting, the stool becomes frequent 5-10 times a day or more, it is mushy or liquid, watery, plentiful, undigested, with white lumps, a small admixture of clear mucus, greens and a sharp acidic odor. The abdomen is moderately inflated, with palpation characterized by a rumbling all over the abdomen). Body temperature rises to subfebrile values. Possible development of toxicosis with exsicosis. The course of the disease is longer, the diarrhea syndrome can persist up to 2-3 weeks, accompanied by a repeated, sometimes prolonged bacterial release.
• The granular form of salmonellosis is isolated, rarely and, according to clinical manifestations, reminds shigellosis. As with shigellosis, the onset of the disease is acute, with a rise in temperature, the appearance of symptoms of intoxication and political syndrome: pain along the colon, liquid, neobylnogo, stool with a lot of turbid mucus, often greenery and veins of blood. In contrast to shigellosis, the manifestations of the toxic syndrome are more prolonged, the symptoms of distal colitis (tenesmus, sigmoid colon contractility, anus compliance, etc.) are absent or appear from the first days of the disease, but on the 3-5th day, the stool, as a rule, remains caloric.
• Gastroenterocolitis and enterocolitis are the most common manifestations of salmonella infection in children of any age, accounting for more than half (53.2-67%) of all clinical variants of the disease. The disease begins acutely, the severity of the main symptoms gradually increases within 3-5 days. From the first days of the disease there is a rapid increase. A copious liquid stool containing feces mixed with water, often a stinking stool, with a lot of turbid mucus and greens. The color and consistency of feces often resemble "marsh mud" or "frog eggs" (a dark green foamy mass consisting of slugs of mucus). In rare cases, the symptoms of distal colitis in the form of spasmodic sigmoid colon, anus compliance, tenesmus or their equivalents (in young children - straining and redness of the face, anxiety before defecation).

Vomiting with gastroenterocolitic form of salmonellosis is infrequent, but persistent, appears periodically, not every day, is not associated with the intake of food, water and medicines ("unmotivated"), persists throughout the acute period of the disease.

When examining children, attention is attracted by a thickly lined, sometimes thickened tongue with traces of teeth, a moderately swollen abdomen ("full belly"), and in young children - hepatosplenomegaly. Children with salmonella infection, usually sluggish, drowsy, inhibited, adynamic, appetite significantly reduced.

The body temperature rises from the first day of the illness, reaches a maximum by the 3-4th day and lasts on average 5-7 days. Sometimes the febrile period is prolonged to 2-3 weeks or more. Despite the ongoing, seemingly adequate therapy, the effects of intoxication persist, the stool is normalized slowly (by the 7th-10th day and later), often marked by prolonged bacterial excretion.

The typhoid-like form of salmonella is in recent years no more than 1-2% of all forms of salmonellosis and is mainly in older children. With this form, marked bacteremia and toxic syndrome are noted. According to clinical manifestations, the disease resembles a paratyphoid. The disease begins acutely, with a rise in body temperature to high values (39-40 ° C), headache, vomiting, loss of appetite, adynamia, deafness. Early and fairly constant symptoms: nonsense, obscuration of consciousness, the phenomenon of meningism. The tongue is densely covered with plaque, thickened (often with traces of teeth), dryish ("typhoid tongue"). The abdomen is moderately inflated, palpation is determined by rumbling and diffuse soreness in the right ileal region. From the 4th-6th day of the disease, in most patients, the liver and spleen increase. At the height of the disease, a neoplastic rosaceous-papular rash may appear. Intestinal disorders may not be, but most children from the first days of illness observe enteritis stool. Young children often get pneumonia, otitis, which makes differential diagnosis difficult with typhoid fever.

The duration of the febrile period is usually up to 2 weeks, the normalization of body temperature occurs most often as a type of truncated lysis. In some cases, there are relapses of the disease.

The septic form of salmonellosis occurs in newborns, prematurity and infants who are breastfed, weakened by previous diseases. This form of salmonella infection can develop as a result of generalization of the process with gastrointestinal forms or without previous damage to the gastrointestinal tract, as primary salmonella sepsis. Often, it is a mixed infection. The disease begins sharply, with the rise in body temperature, which is kept on high numbers up to 3-4 weeks with large swings during the day. There are purulent foci in various organs with the formation of a clinical picture of purulent meningitis, pneumonia, otitis, pyelonephritis, etc. Arthritis and osteomyelitis sometimes occur. There are cases of salmonella peritonitis, endocarditis, lung abscess.

Specific symptoms characteristic of salmonella sepsis, no, but still the disease is often accompanied by a rapid chair with pathological impurities. The specificity of multiple foci of inflammation is confirmed by the detection of salmonella bacteriological method in cerebrospinal fluid (with purulent meningitis), sputum (with pneumonia), urine (with urinary tract infection), synovial fluid (with arthritis), etc.

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